|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,725.37
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,937.34
|
| Rate for Payer: ASR Commercial |
$2,937.34
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,479.78
|
| Rate for Payer: BCN Commercial |
$2,347.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,846.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,028.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,937.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,725.37
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,653.30
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,122.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,664.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,968.32 |
| Max. Negotiated Rate |
$3,028.19 |
| Rate for Payer: Aetna Commercial |
$2,725.37
|
| Rate for Payer: ASR ASR |
$2,937.34
|
| Rate for Payer: ASR Commercial |
$2,937.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,467.67
|
| Rate for Payer: BCN Commercial |
$2,347.76
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,846.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Healthscope Commercial |
$3,028.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,937.34
|
| Rate for Payer: Mclaren Commercial |
$2,725.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,664.81
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$844.74 |
| Max. Negotiated Rate |
$1,299.60 |
| Rate for Payer: Aetna Commercial |
$1,169.64
|
| Rate for Payer: ASR ASR |
$1,260.61
|
| Rate for Payer: ASR Commercial |
$1,260.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,059.04
|
| Rate for Payer: BCN Commercial |
$1,007.58
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,221.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Healthscope Commercial |
$1,299.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.61
|
| Rate for Payer: Mclaren Commercial |
$1,169.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.65
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$844.74 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$1,169.64
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$1,260.61
|
| Rate for Payer: ASR Commercial |
$1,260.61
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.24
|
| Rate for Payer: BCN Commercial |
$1,007.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,221.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,299.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$1,169.64
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.71
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$911.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.59 |
| Max. Negotiated Rate |
$663.93 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: Aetna Medicare |
$428.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$535.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$535.42
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Complete |
$241.07
|
| Rate for Payer: BCBS MAPPO |
$428.34
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: BCN Medicare Advantage |
$428.34
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.34
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$428.34
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Mclaren Medicaid |
$229.59
|
| Rate for Payer: Mclaren Medicare |
$428.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.76
|
| Rate for Payer: Meridian Medicaid |
$241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$492.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Medicare |
$406.92
|
| Rate for Payer: PACE SWMI |
$428.34
|
| Rate for Payer: PHP Commercial |
$471.17
|
| Rate for Payer: PHP Medicaid |
$229.59
|
| Rate for Payer: PHP Medicare Advantage |
$428.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.07
|
| Rate for Payer: Priority Health Medicare |
$428.34
|
| Rate for Payer: Priority Health Narrow Network |
$408.88
|
| Rate for Payer: Railroad Medicare Medicare |
$428.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.34
|
| Rate for Payer: UHC Exchange |
$663.93
|
| Rate for Payer: UHC Medicare Advantage |
$428.34
|
| Rate for Payer: UHCCP DNSP |
$428.34
|
| Rate for Payer: UHCCP Medicaid |
$229.59
|
| Rate for Payer: VA VA |
$428.34
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Trust/PPO |
$475.31
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,388.40 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$3,307.01
|
| Rate for Payer: Aetna Medicare |
$5,296.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: ASR ASR |
$3,564.23
|
| Rate for Payer: ASR Commercial |
$3,564.23
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,009.02
|
| Rate for Payer: BCN Commercial |
$2,848.81
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,453.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$3,674.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,564.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$3,307.01
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$5,826.04
|
| Rate for Payer: PHP Medicaid |
$2,838.87
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,219.56
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,575.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,233.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$8,209.42
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP DNSP |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: VA VA |
$5,296.40
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,388.40 |
| Max. Negotiated Rate |
$3,674.46 |
| Rate for Payer: Aetna Commercial |
$3,307.01
|
| Rate for Payer: ASR ASR |
$3,564.23
|
| Rate for Payer: ASR Commercial |
$3,564.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,994.32
|
| Rate for Payer: BCN Commercial |
$2,848.81
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,453.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Healthscope Commercial |
$3,674.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,564.23
|
| Rate for Payer: Mclaren Commercial |
$3,307.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,233.52
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$597.16 |
| Max. Negotiated Rate |
$918.71 |
| Rate for Payer: Aetna Commercial |
$826.84
|
| Rate for Payer: ASR ASR |
$891.15
|
| Rate for Payer: ASR Commercial |
$891.15
|
| Rate for Payer: BCBS Trust/PPO |
$748.66
|
| Rate for Payer: BCN Commercial |
$712.28
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$863.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$918.71
|
| Rate for Payer: Healthscope Whirlpool |
$891.15
|
| Rate for Payer: Mclaren Commercial |
$826.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.46
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$1,199.82 |
| Rate for Payer: Aetna Commercial |
$826.84
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$891.15
|
| Rate for Payer: ASR Commercial |
$891.15
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$752.33
|
| Rate for Payer: BCN Commercial |
$712.28
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$863.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$918.71
|
| Rate for Payer: Healthscope Whirlpool |
$891.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$826.84
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,095.82
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$876.66
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$1,199.82 |
| Rate for Payer: Aetna Commercial |
$911.84
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$982.76
|
| Rate for Payer: ASR Commercial |
$982.76
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$829.67
|
| Rate for Payer: BCN Commercial |
$785.50
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$952.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$1,013.15
|
| Rate for Payer: Healthscope Whirlpool |
$982.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$911.84
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: Nomi Health Commercial |
$830.78
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,095.82
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$876.66
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$891.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$658.55 |
| Max. Negotiated Rate |
$1,013.15 |
| Rate for Payer: Aetna Commercial |
$911.84
|
| Rate for Payer: ASR ASR |
$982.76
|
| Rate for Payer: ASR Commercial |
$982.76
|
| Rate for Payer: BCBS Trust/PPO |
$825.62
|
| Rate for Payer: BCN Commercial |
$785.50
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$952.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Healthscope Commercial |
$1,013.15
|
| Rate for Payer: Healthscope Whirlpool |
$982.76
|
| Rate for Payer: Mclaren Commercial |
$911.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: Nomi Health Commercial |
$830.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$891.57
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$884.55 |
| Max. Negotiated Rate |
$1,360.85 |
| Rate for Payer: Aetna Commercial |
$1,224.76
|
| Rate for Payer: ASR ASR |
$1,320.02
|
| Rate for Payer: ASR Commercial |
$1,320.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.96
|
| Rate for Payer: BCN Commercial |
$1,055.07
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,279.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Healthscope Commercial |
$1,360.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,320.02
|
| Rate for Payer: Mclaren Commercial |
$1,224.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$1,115.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,197.55
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$1,360.85 |
| Rate for Payer: Aetna Commercial |
$1,224.76
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$1,320.02
|
| Rate for Payer: ASR Commercial |
$1,320.02
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,114.40
|
| Rate for Payer: BCN Commercial |
$1,055.07
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,279.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$1,360.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,320.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$1,224.76
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$1,115.90
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,095.82
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$876.66
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,197.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$8.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.92
|
| Rate for Payer: ASR ASR |
$44.55
|
| Rate for Payer: ASR Commercial |
$44.55
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$37.61
|
| Rate for Payer: BCN Commercial |
$35.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$45.93
|
| Rate for Payer: Healthscope Whirlpool |
$44.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.74
|
| Rate for Payer: Mclaren Commercial |
$41.34
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: Nomi Health Commercial |
$37.66
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Medicaid |
$4.68
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.15
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health Narrow Network |
$41.72
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Exchange |
$13.55
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: UHCCP DNSP |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$8.74
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.85 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: ASR ASR |
$44.55
|
| Rate for Payer: ASR Commercial |
$44.55
|
| Rate for Payer: BCBS Trust/PPO |
$37.43
|
| Rate for Payer: BCN Commercial |
$35.61
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$45.93
|
| Rate for Payer: Healthscope Whirlpool |
$44.55
|
| Rate for Payer: Mclaren Commercial |
$41.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: Nomi Health Commercial |
$37.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.42
|
|
|
HC IRON LEVEL
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.15
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$41.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$230.50 |
| Max. Negotiated Rate |
$576.25 |
| Rate for Payer: Aetna Commercial |
$518.62
|
| Rate for Payer: Aetna Medicare |
$288.12
|
| Rate for Payer: ASR ASR |
$558.96
|
| Rate for Payer: ASR Commercial |
$558.96
|
| Rate for Payer: BCBS Complete |
$230.50
|
| Rate for Payer: BCBS Trust/PPO |
$471.89
|
| Rate for Payer: BCN Commercial |
$446.77
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$541.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$576.25
|
| Rate for Payer: Healthscope Whirlpool |
$558.96
|
| Rate for Payer: Mclaren Commercial |
$518.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: Nomi Health Commercial |
$472.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.91
|
| Rate for Payer: Priority Health Narrow Network |
$403.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.10
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$374.56 |
| Max. Negotiated Rate |
$576.25 |
| Rate for Payer: Aetna Commercial |
$518.62
|
| Rate for Payer: ASR ASR |
$558.96
|
| Rate for Payer: ASR Commercial |
$558.96
|
| Rate for Payer: BCBS Trust/PPO |
$469.59
|
| Rate for Payer: BCN Commercial |
$446.77
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$541.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$576.25
|
| Rate for Payer: Healthscope Whirlpool |
$558.96
|
| Rate for Payer: Mclaren Commercial |
$518.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: Nomi Health Commercial |
$472.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.10
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,654.95 |
| Max. Negotiated Rate |
$11,637.37 |
| Rate for Payer: Aetna Commercial |
$10,473.63
|
| Rate for Payer: Aetna Medicare |
$5,818.68
|
| Rate for Payer: ASR ASR |
$11,288.25
|
| Rate for Payer: ASR Commercial |
$11,288.25
|
| Rate for Payer: BCBS Complete |
$4,654.95
|
| Rate for Payer: BCBS Trust/PPO |
$9,529.84
|
| Rate for Payer: BCN Commercial |
$9,022.45
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,939.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$11,637.37
|
| Rate for Payer: Healthscope Whirlpool |
$11,288.25
|
| Rate for Payer: Mclaren Commercial |
$10,473.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: Nomi Health Commercial |
$9,542.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,196.66
|
| Rate for Payer: Priority Health Narrow Network |
$8,157.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,240.89
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,564.29 |
| Max. Negotiated Rate |
$11,637.37 |
| Rate for Payer: Aetna Commercial |
$10,473.63
|
| Rate for Payer: ASR ASR |
$11,288.25
|
| Rate for Payer: ASR Commercial |
$11,288.25
|
| Rate for Payer: BCBS Trust/PPO |
$9,483.29
|
| Rate for Payer: BCN Commercial |
$9,022.45
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,939.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$11,637.37
|
| Rate for Payer: Healthscope Whirlpool |
$11,288.25
|
| Rate for Payer: Mclaren Commercial |
$10,473.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: Nomi Health Commercial |
$9,542.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,240.89
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,383.04 |
| Max. Negotiated Rate |
$3,457.60 |
| Rate for Payer: Aetna Commercial |
$3,111.84
|
| Rate for Payer: Aetna Medicare |
$1,728.80
|
| Rate for Payer: ASR ASR |
$3,353.87
|
| Rate for Payer: ASR Commercial |
$3,353.87
|
| Rate for Payer: BCBS Complete |
$1,383.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,831.43
|
| Rate for Payer: BCN Commercial |
$2,680.68
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$3,250.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,457.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,353.87
|
| Rate for Payer: Mclaren Commercial |
$3,111.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,029.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.69
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,247.44 |
| Max. Negotiated Rate |
$3,457.60 |
| Rate for Payer: Aetna Commercial |
$3,111.84
|
| Rate for Payer: ASR ASR |
$3,353.87
|
| Rate for Payer: ASR Commercial |
$3,353.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,817.60
|
| Rate for Payer: BCN Commercial |
$2,680.68
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$3,250.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,457.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,353.87
|
| Rate for Payer: Mclaren Commercial |
$3,111.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.69
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,401.96
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,511.27 |
| Max. Negotiated Rate |
$5,401.96 |
| Rate for Payer: Aetna Commercial |
$4,861.76
|
| Rate for Payer: ASR ASR |
$5,239.90
|
| Rate for Payer: ASR Commercial |
$5,239.90
|
| Rate for Payer: BCBS Trust/PPO |
$4,402.06
|
| Rate for Payer: BCN Commercial |
$4,188.14
|
| Rate for Payer: Cash Price |
$4,321.57
|
| Rate for Payer: Cofinity Commercial |
$5,077.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,321.57
|
| Rate for Payer: Healthscope Commercial |
$5,401.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,239.90
|
| Rate for Payer: Mclaren Commercial |
$4,861.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,591.67
|
| Rate for Payer: Nomi Health Commercial |
$4,429.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,511.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,753.72
|
|
